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level: Level 1

Questions and Answers List

level questions: Level 1

QuestionAnswer
What should you attempt to maintain the PTs ETCO2 values ?35-45 mmHg
to address hypoxemia and hypotension, hyperventilate PT ETCO2 values at30-35 mmHg
some signs of cerebral herniationDeteriorating GCS <9 with any of the following - dilated/ unreactive pupils, asymmetric pupillary response, asymmetric motor response or motor exam extension posturing or no response
if ETCO2 monitoring is unavailable how any bpm should you hyperventilate an adult that is showing hypoxemia and hypotensionapprox. 20 bpm
if ETCO2 monitoring is unavailable what bpm should you hyperventilate an child that is showing hypoxemia and hypotensionapprox. 25 bpm
if ETCO2 monitoring is unavailable how many bpm should you hyperventilate an infant <1yr that is showing hypoxemia and hypotensionapprox. 30 bpm
GCSGlasgow Coma Scale
lowest score a PT can get on the GCS3
most common head #Linar # at 80%
halo signblood mixed w/CSF from nose, mouth, ears
what is the wave the a bullet causescavitational wave
Retroauricular Ecchymosisblood pooling below ear
Epidural Hematomableeding between mater and skull, involves arterial bleed, ICP builds up quickly
Subdural HematomaMore common - bleeding w/in meninges, usually venous bleed, complaints of focal symptoms , occurs above pia mater
Intracerebral HematomaRupture blood vessel w/in brain, presentation similar to stroke
DAIDiffuse Axonal Injury (stretching or tearing of nerve fibres w.subsequent axonal damage)
Hallmark of ConcussionThey only improve
Retrograde amnesiaforgetting events prior to incident
Anterograde amnesiaforgetting events post incident
Reduced levels on CO2 in CSFcerebral vasoconstriction - results in cerebral anoxia
As CO2 levels rise in CSFcerebral arteries dilate - encourage blood flow - reduce hypercarbia
Already high ICPcauses classic hyperventilation and hypertension
Severe Diffuse Axonal InjuryBrainstem injury, significant mechanical disruption, high mortality rate
Presentation of Severe Diffuse Axonal Injuryprolonged unconsciousness, cushings reflex, decorticate or decerebrate posturing
if a PT responds with painful stimuli , confusion and localizes to pain ... what level of GCS would they be11
If a PT responds with verbal stimuli, inappropriate words and abnormal flexion what level of GCS would they be9
if the PT has spontaneous eye response, is oriented but has no motor functions what level of GCS would they be10
if the PT responds to painful stimuli, uses uncomprehending sounds and has abnormal extension what GCS level would they be6
what is the highest level of GCS can a PT get15
Herniationportion of the brain structure pushed through opening (foramen magnum), pressure on upper brain (vomiting, decreased LOC, pupil dilation), pressure on medulla oblongata ( disturbs respiration, BP, HR)
Cushing's Reflexincreasing BP, slowing pulse rate, erratic/irregular respirations
what kind of posturing would be present with an upper brainstem compressiondecorticate posturing
what kind of posturing would be present with an middle brainstem compressiondecerebrate posturing
PT is on spinal board with no indicated SMR and is conscious elevate the head ___ degrees30
What is the best predictor for head injuryLOC
Apply constant pressure to the soft parts of the nares for ? minute intervals5
can you remove a foreign object from eyeyes, only if the object is not on the cornea and is visible, accessible and easily removed
HyphemaBlunt trauma to the anterior chamber of the eye, blood in front of iris or pupil
what medication is used for head injuriesMannitol (Diuretic)